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What Exercises Are Best for Neck Pain?

16 Jul

Past research has demonstrated that combining spinal manipulative therapy (SMT) with exercise yields the best long-term results for individuals with neck pain. So what exercises should we consider when neck pain rears its ugly head?

In the acute phase of an injury, rest and ice may be appropriate, but patients will often benefit from lightly applied isometric exercises. Place your hand against the side of your head and lightly push your head into your hand for a count of five seconds. If tolerated, tip your head sideways five to ten degrees and repeat the process. This can be repeated multiple times at progressively greater angles until you’ve accessed your full range of motion (ROM).

The above isometric exercise can be repeated in the opposite direction as well as forwards, backwards, and into left and right rotation directions. The KEY is to always stay within reasonable pain boundaries—no sharp/”bad” pain allowed!

You can then move on to isotonic neck exercises. Using the same amount of light pressure, gently push your head into your hand as you did before, but this time, allow the head to move slowly toward the shoulder against the pressure of the hand. This too can be repeated on the opposite side, forwards, backwards, and into left and right rotation.

Using only one or two fingers rather than the whole hand helps to prevent you from pushing too hard with your hand or head when performing isometrics or isotonic exercises. Also, the same movements of the head can be done without any hand/finger resistance, but faster results seem to occur when pressure is applied.

Studies also show that weakness of the deep neck flexor muscles is very common in people with chronic (more than three months) neck pain. These are deep, involuntary muscles, so to properly strengthen them, look straight ahead, tuck in your chin as far as you can, hold for five to ten seconds, and repeat five to ten times.

Beyond treatment options for neck pain such as spinal manipulation, mobilization, and exercise, your doctor of chiropractic may utilize soft tissue therapies such as myofascial release, active release technique, as well as various physical therapy modalities, ergonomic modifications, and more in the effort to help you get out of pain and return to your normal activities.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.
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What Treatments Work Best for Neck Pain?

18 Jun

Experts estimate that up to 70% of people will experience an episode of neck pain in their lifetime. Though there are many potential forms of treatment available, little has been published comparing the various treatment options available to the neck pain patient.

A 2012 study that involved 272 neck pain patients compared three treatment options: chiropractic, medication, and exercise. After twelve weeks of treatment, the patients who received either chiropractic care or exercise instruction reported the greatest reduction in pain. The researchers followed up with the participants for up to a year and found that the patients in the chiropractic and exercise groups continued to report less pain than those in the medication group, and these benefits persisted until the end of the study. The researchers concluded that participants from both the chiropractic care and exercise therapy groups had more than double the likelihood of complete pain relief than with the patients in the medication group.

Quality studies on the short- and medium- term benefits of exercise and manual therapies applied to the cervical spine for patients with neck pain have been published since the 1980s. However, the benefits over the long term are not as well documented. With this in mind, a 2002 study followed 191 patients with chronic neck pain for two years comparing spinal manipulation (SM) with and without one of two types of exercises: low-tech (and low cost) rehabilitative exercise (LTEx) or high-tech MedX (machine assisted) rehabilitative exercises (HTEx).

The research team randomly assigned the 191 patients to eleven weeks of one of three treatments: SM only; SM + LTEx; or SM + HTEx. The investigators evaluated the patients at the start of the study, again after five weeks of treatment, and finally following the conclusion of the treatment phase of the study at eleven weeks. They followed-up with the patients three, six, twelve, and 24 months later as well.

The results showed that SM + LTEx and SM + HTEx were both superior to SM alone at both one- and two-year time points. Overall, the patients in the SM + LTEx group reported the greatest pain reduction and satisfaction with care. This finding is even more important, as the care delivered to the SM + LTEx group costs less than care involving specialized, more expensive equipment.

It’s clear that chiropractic care that includes spinal manipulation and/or mobilization with exercise training yields the best long-term outcomes. Add to that the use of soft tissue therapies such as myofascial release, active release technique, and various modalities, and chiropractic is CLEARLY the best choice for patients with acute or chronic neck pain.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Are Neck Pain and Dizziness Related?

17 May

According to the Vestibular Disorders Association, there is a classification of dizziness called “cervicogenic dizziness”, or dizziness resulting from neck pain. Published reports have linked the influence of head position on equilibrium as far back as the mid-1800s, but it wasn’t until 1955 when researchers coined the term “cervical vertigo” to describe a clinical condition relating neck pain and/or injury to dizziness and disequilibrium. These days, cervicogenic dizziness (CD) is considered the more accurate diagnosis for this syndrome.

There are a number of neck-related diagnoses that can cause dizziness or disorientation including cervical spondylosis (spurs), cervical trauma (like whiplash), and cervical arthritis (osteoarthritis being the most common).

Unfortunately, there is no “gold-standard” test to confirm or rule out that the neck is the cause of one’s dizziness. A physical examination in a chiropractic clinic will seek to eliminate other causes of dizziness such as inner ear dysfunction (labyrinthitis or vestibular dysfunction) and/or other nervous system problems. Your doctor of chiropractic will also examine the eyes by carefully looking for oscillating eye motion (called nystagmus) in six different positions of end-range gaze. A diagnosis of CD is then made once all other causes of dizziness have been ruled out.

Symptoms of CD usually occur after the onset of neck pain. They’re often described as a sensation of movement that worsens with head movement or after prolonged time in one position. Such dizziness can last minutes to hours. A general sensation of imbalance occurs with head movement and/or with movement in the environment (like looking out of window of a fast-moving train, plane, or vehicle). Headache may accompany the dizziness and neck pain. Generally, as neck pain reduces so does the dizziness.

Because CD can result from trauma such as whiplash or head injury, treatment aimed at resolving the patient’s neck pain will usually resolve their symptoms of dizziness as well.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Slouching – Does It Really Matter?

23 Apr

Last month, we discussed how slouching can contribute to neck pain and headaches, but we didn’t go into any detail about the other negative health ramifications of bad posture.

DIGESTION: Prolonged sitting is bad enough all by itself, but adding a slouched, slumped posture can distort or compromise the space that houses internal organs and negatively affect MANY vital functions, including digestion. This can lead to complaints including (but not limited to) discomfort, constipation, and heart burn.

BREATHING: Slouching can also reduce the space occupied by the lungs, hindering the ability to take in a deep breath and/or force air out of the lungs. This is the reason why good conductors have their musicians sit up straight with both feet on the floor (it’s not just to “look good”)!

MOOD: Did you know that sitting for seven or more hours per day increases the risk of depression by 47% compared with sitting for four hours a day or less? Our energy levels also decrease with prolonged poor posture, further complicating this negative side effect.

WORK PERFORMANCE: Researchers have observed that sitting up straight increases alertness, reduces fatigue, and improves productivity. Moreover, co-workers may conclude that someone slumped over their desk is unmotivated, disinterested, or at the least, tired. Sit/stand workstations are gaining popularity, especially with the availability of low-cost options to transform a traditional desk into a standing desk. Studies show improved work performance when we have the option to change positions as needed during the day. Exercises you can perform at your desk, such as chin retractions, help strengthen the deep neck flexor muscles, which can help reduce poor neck posture. Stretching the chest muscles and keeping the “core” fit with pelvic stabilization exercises are also GREAT methods to improve our sitting posture!

VARICOSE VEINS: Prolonged sitting raises the risk for the formation of spider veins, especially in women, which can lead to varicose veins. Compression from sitting alters the flow of blood into the legs, and a proper fitting chair and sitting “correctly” can reduce the risk of developing circulatory dysfunction leading to varicosities or worse, blood clots.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Does Slouching Cause Neck and Shoulder Pain?

22 Mar

In a 2015 study, Swedish researchers compared the effect of a slouched vs. normal body posture with regards to performing lifting tasks.

In particular, investigators wanted a better understanding of how a slouched posture affects neck and shoulder function and muscle activity in three large muscle groups—the upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA)—during arm elevation to see if it affects range of motion, muscle activation patterns, maximal muscle activity, and total muscle work.

Study participants—non-injured, young adult males—perform maximum arm elevations in upright and slouched postures that researchers observed using a combined 3D movement and EMG (electromyography) assessment system. This measured the arm range of motion, velocity, and spine curvature simultaneously with EMG activity in the UT, LT, and SA muscles.

The research team found that participants in the slouched position experienced significantly less arm elevation and decreased movement velocity both upwards and downwards, in addition to increased peak muscle activity (that is, the muscles had to work harder) in all three muscles tested.

It appears that increased thoracic kyphosis (slouching) leads to a marked increase in physical requirements when performing simple arm movements. Over time, such changes in function could place added stress on the muscles, tissues, and joints of the neck and shoulder, leading to pain and injury. These findings add to a growing body of research regarding the detrimental long-term effects of poor posture as well as an understanding of how exactly faulty postures increase the risk of musculoskeletal disorders.

In their conclusion, the authors of the study write, “[Patients] suffering from neck-shoulder pain and disability should be investigated and treated for defective thoracic curvature issues.”

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Sick & Tired of Neck Pain?

15 Feb

For most of us, neck pain has reared its ugly head more than once. In fact, there are estimates that anywhere from one-in-ten to one-in-five people will experience an episode of neck pain in a given year. Though some studies report that between 33% and 65% of these people will recover within twelve months, many individuals will experience either a relapse of their neck pain or their neck pain will become a chronic health issue.

So what can a doctor of chiropractic do about it? The answer is simple: spinal manipulation (SM) and exercise. Spinal manipulation is the most common form of treatment delivered in a chiropractic setting, and many studies note that neck pain is the second most common reason patients seek chiropractic care (back pain is number one). Regarding exercise, patients may be advised to engage in stretching exercise, strengthening exercises, or both.

For example, after an hour of seated computer work, one might experience muscle fatigue from prolonged static postures, especially for those outside of a neutral position. For this scenario, here’s a great STRETCH option to do every 30-60 minutes (yes, SET A TIMER): 1) Tuck the chin (and keep it tucked); 2) reach with the right hand over the top of the head and gently pull the right ear toward the shoulder while the left hand reaches down to the floor (as if to pick up a dollar bill); 3) next, nod the head (as if gesturing “yes”) multiple times; 4) follow this by shaking the head left to right (as if gesturing “no”); 5) repeat steps one through four with the head/neck flexed forward and backwards, “searching” for the tightest spots and “work” them until they loosen up. Repeat on the opposite side.

Here is an exercise to STREGTHEN the neck muscles. 1) Tuck in the chin while looking straight ahead; 2) place the back of your second and third fingers under your chin and nod (up/down) against mild resistance; 3) repeat five to ten times SLOWLY; 4)  repeat steps one through three with head/neck flexed forward and then again backwards (looking towards the ceiling). Repeat multiple times each day.

The KEY is to set the timer to remind you to do these! If you have significant forward head carriage and rounded shoulders, your doctor of chiropractic can show you addition important exercises, but this will be a great start for you to gain control over that chronic, recurring neck pain that you’ve been putting up with for far too long!